■随着人口老龄化和老年患者非酒精性脂肪性肝炎(NASH)和肝细胞癌(HCC)的患病率升高,越来越多的活体供者肝移植(LDLTs)被考虑在这组患者中,因为死亡供者肝移植的资格仅限于年龄在65岁及以下的患者.然而,印度没有报告该组的短期和长期结果,没有健全的国家卫生计划。这项研究的目的是为该组的移植提供指导。
研究了2006年1月至2017年12月在我们中心接受LDLT的所有60岁及以上患者(第1组)。以1:2比例创建倾向评分匹配的组,其具有相当的性别和终末期肝病模型评分(组2)。比较两组患者的住院时间,手术并发症,医院死亡率和1,3年和5年生存率。
■第一组由207名患者组成,第2组有414例患者。第1组的患者数量从2006年的4例逐渐增加到2017年的33例,占总病例的15%。第一组有更多的病毒性肝炎患者,NASH和HCC,由于心肺并发症,他们有更高的30天死亡率。尽管1年和3年生存率相似,第1组的5年生存率显著较低.
■由于心肺并发症和HCC复发,老年组的5年生存率较低。通过更好的患者选择和预防HCC复发,可以改善老年组的预后。
UNASSIGNED: With ageing population and higher prevalence of nonalcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC) in older patients, more and more living donor liver transplants (LDLTs) are being considered in this group of patients as eligibility for deceased donor liver transplant is restricted to those aged 65 years and younger. However, the short- and long-term outcomes of this group have not been reported from India, which does not have a robust national health scheme. The aim of this study was to provide guidelines for transplant in this group.
UNASSIGNED: All patients aged 60 years and older (group 1) who underwent LDLT in our centre between January 2006 and December 2017 were studied. A propensity score-matched group in 1:2 ratio was created with comparable sex and Model for End-Stage Liver Disease score (group 2). The 2 groups were compared for duration of hospital stay, surgical complications, hospital mortality and 1-, 3- and 5-year survival.
UNASSIGNED: Group 1 consisted of 207 patients, and group 2 had 414 patients. The number of patients in group 1 gradually increased with time from 4 in 2006 to 33 in 2017 accounting for 15% of total cases. Group 1 had more patients with viral hepatitis, NASH and HCC, and they had a higher 30-day mortality due to cardiorespiratory complications. Although 1- and 3-year survival was similar, the 5-year survival was significantly lower in group 1.
UNASSIGNED: Five-year survival was lower in the elderly group due to cardiorespiratory complications and recurrence of HCC. Outcomes in the elderly group can be improved with better patient selection and preventing HCC recurrence.